|
HC CLOSED TX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
76100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.91 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: BCBS Trust/PPO |
$283.50
|
| Rate for Payer: BCN Commercial |
$283.50
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
|
HC CLOSED TX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
76100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.52 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: Aetna Medicare |
$89.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.27
|
| Rate for Payer: BCBS Complete |
$63.54
|
| Rate for Payer: BCBS MAPPO |
$85.81
|
| Rate for Payer: BCBS Trust/PPO |
$282.19
|
| Rate for Payer: BCN Commercial |
$282.19
|
| Rate for Payer: BCN Medicare Advantage |
$85.81
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.81
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Mclaren Medicaid |
$60.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.11
|
| Rate for Payer: Meridian Medicaid |
$63.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PACE Senior Care Partners |
$81.52
|
| Rate for Payer: PACE SWMI |
$85.81
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: PHP Medicare Advantage |
$85.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Medicare |
$86.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: Railroad Medicare Medicare |
$85.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: UHC Exchange |
$85.81
|
| Rate for Payer: UHC Medicaid |
$60.52
|
| Rate for Payer: UHC Medicare Advantage |
$85.81
|
| Rate for Payer: UHCCP Medicaid |
$60.52
|
| Rate for Payer: VA VA |
$85.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
|
HC CLOSED TX TALUS FX; W/O MANIP
|
Facility
|
OP
|
$297.49
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
76100288
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$52.45 |
| Max. Negotiated Rate |
$267.74 |
| Rate for Payer: Aetna Commercial |
$252.87
|
| Rate for Payer: Aetna Medicare |
$77.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$92.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$92.97
|
| Rate for Payer: BCBS Complete |
$55.07
|
| Rate for Payer: BCBS MAPPO |
$74.37
|
| Rate for Payer: BCBS Trust/PPO |
$244.57
|
| Rate for Payer: BCN Commercial |
$244.57
|
| Rate for Payer: BCN Medicare Advantage |
$74.37
|
| Rate for Payer: Cash Price |
$237.99
|
| Rate for Payer: Cofinity Commercial |
$255.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.37
|
| Rate for Payer: Healthscope Commercial |
$267.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.12
|
| Rate for Payer: Mclaren Medicaid |
$52.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.09
|
| Rate for Payer: Meridian Medicaid |
$55.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.87
|
| Rate for Payer: Nomi Health Commercial |
$243.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.12
|
| Rate for Payer: PACE Senior Care Partners |
$70.65
|
| Rate for Payer: PACE SWMI |
$74.37
|
| Rate for Payer: PHP Commercial |
$252.87
|
| Rate for Payer: PHP Medicare Advantage |
$74.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.82
|
| Rate for Payer: Priority Health Medicare |
$75.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.05
|
| Rate for Payer: Railroad Medicare Medicare |
$74.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.79
|
| Rate for Payer: UHC Core |
$248.40
|
| Rate for Payer: UHC Exchange |
$74.37
|
| Rate for Payer: UHC Medicaid |
$52.45
|
| Rate for Payer: UHC Medicare Advantage |
$74.37
|
| Rate for Payer: UHCCP Medicaid |
$52.45
|
| Rate for Payer: VA VA |
$74.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.12
|
|
|
HC CLOSED TX TALUS FX; W/O MANIP
|
Facility
|
IP
|
$297.49
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
76100288
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$207.05 |
| Max. Negotiated Rate |
$267.74 |
| Rate for Payer: Aetna Commercial |
$252.87
|
| Rate for Payer: BCBS Trust/PPO |
$245.70
|
| Rate for Payer: BCN Commercial |
$245.70
|
| Rate for Payer: Cash Price |
$237.99
|
| Rate for Payer: Cofinity Commercial |
$255.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.99
|
| Rate for Payer: Healthscope Commercial |
$267.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$223.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.87
|
| Rate for Payer: Nomi Health Commercial |
$243.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$223.12
|
| Rate for Payer: PHP Commercial |
$252.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$258.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$207.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$261.79
|
| Rate for Payer: UHC Core |
$248.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$223.12
|
|
|
HC CLOSED TX TOE FX W MANIPULATION
|
Facility
|
IP
|
$635.11
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
76100438
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$442.04 |
| Max. Negotiated Rate |
$571.60 |
| Rate for Payer: Aetna Commercial |
$539.84
|
| Rate for Payer: BCBS Trust/PPO |
$524.54
|
| Rate for Payer: BCN Commercial |
$524.54
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cofinity Commercial |
$546.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.09
|
| Rate for Payer: Healthscope Commercial |
$571.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.84
|
| Rate for Payer: Nomi Health Commercial |
$520.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$476.33
|
| Rate for Payer: PHP Commercial |
$539.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$552.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$442.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.90
|
| Rate for Payer: UHC Core |
$530.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.33
|
|
|
HC CLOSED TX TOE FX W MANIPULATION
|
Facility
|
OP
|
$635.11
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
76100438
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.97 |
| Max. Negotiated Rate |
$571.60 |
| Rate for Payer: Aetna Commercial |
$539.84
|
| Rate for Payer: Aetna Medicare |
$165.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$198.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$198.47
|
| Rate for Payer: BCBS Complete |
$117.56
|
| Rate for Payer: BCBS MAPPO |
$158.78
|
| Rate for Payer: BCBS Trust/PPO |
$522.12
|
| Rate for Payer: BCN Commercial |
$522.12
|
| Rate for Payer: BCN Medicare Advantage |
$158.78
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cofinity Commercial |
$546.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.78
|
| Rate for Payer: Healthscope Commercial |
$571.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.33
|
| Rate for Payer: Mclaren Medicaid |
$111.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.72
|
| Rate for Payer: Meridian Medicaid |
$117.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$182.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.84
|
| Rate for Payer: Nomi Health Commercial |
$520.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$476.33
|
| Rate for Payer: PACE Senior Care Partners |
$150.84
|
| Rate for Payer: PACE SWMI |
$158.78
|
| Rate for Payer: PHP Commercial |
$539.84
|
| Rate for Payer: PHP Medicare Advantage |
$158.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$552.55
|
| Rate for Payer: Priority Health Medicare |
$160.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$442.04
|
| Rate for Payer: Railroad Medicare Medicare |
$158.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.90
|
| Rate for Payer: UHC Core |
$530.32
|
| Rate for Payer: UHC Exchange |
$158.78
|
| Rate for Payer: UHC Medicaid |
$111.97
|
| Rate for Payer: UHC Medicare Advantage |
$158.78
|
| Rate for Payer: UHCCP Medicaid |
$111.97
|
| Rate for Payer: VA VA |
$158.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.33
|
|
|
HC CLOSED TX TOE FX WO MANIPULATION
|
Facility
|
IP
|
$358.31
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
76100176
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$249.38 |
| Max. Negotiated Rate |
$322.48 |
| Rate for Payer: Aetna Commercial |
$304.56
|
| Rate for Payer: BCBS Trust/PPO |
$295.93
|
| Rate for Payer: BCN Commercial |
$295.93
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$308.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Healthscope Commercial |
$322.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PHP Commercial |
$304.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.31
|
| Rate for Payer: UHC Core |
$299.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.73
|
|
|
HC CLOSED TX TOE FX WO MANIPULATION
|
Facility
|
OP
|
$358.31
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
76100176
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.17 |
| Max. Negotiated Rate |
$322.48 |
| Rate for Payer: Aetna Commercial |
$304.56
|
| Rate for Payer: Aetna Medicare |
$93.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.97
|
| Rate for Payer: BCBS Complete |
$66.32
|
| Rate for Payer: BCBS MAPPO |
$89.58
|
| Rate for Payer: BCBS Trust/PPO |
$294.57
|
| Rate for Payer: BCN Commercial |
$294.57
|
| Rate for Payer: BCN Medicare Advantage |
$89.58
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$308.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.58
|
| Rate for Payer: Healthscope Commercial |
$322.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.73
|
| Rate for Payer: Mclaren Medicaid |
$63.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.06
|
| Rate for Payer: Meridian Medicaid |
$66.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PACE Senior Care Partners |
$85.10
|
| Rate for Payer: PACE SWMI |
$89.58
|
| Rate for Payer: PHP Commercial |
$304.56
|
| Rate for Payer: PHP Medicare Advantage |
$89.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.73
|
| Rate for Payer: Priority Health Medicare |
$90.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.38
|
| Rate for Payer: Railroad Medicare Medicare |
$89.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.31
|
| Rate for Payer: UHC Core |
$299.19
|
| Rate for Payer: UHC Exchange |
$89.58
|
| Rate for Payer: UHC Medicaid |
$63.17
|
| Rate for Payer: UHC Medicare Advantage |
$89.58
|
| Rate for Payer: UHCCP Medicaid |
$63.17
|
| Rate for Payer: VA VA |
$89.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.73
|
|
|
HC CLOSED TX TRIMALLEOLAR FX W/O MANIP
|
Facility
|
OP
|
$719.10
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
76100534
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.78 |
| Max. Negotiated Rate |
$647.19 |
| Rate for Payer: Aetna Commercial |
$611.24
|
| Rate for Payer: Aetna Medicare |
$186.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$224.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$224.72
|
| Rate for Payer: BCBS Complete |
$133.11
|
| Rate for Payer: BCBS MAPPO |
$179.78
|
| Rate for Payer: BCBS Trust/PPO |
$591.17
|
| Rate for Payer: BCN Commercial |
$591.17
|
| Rate for Payer: BCN Medicare Advantage |
$179.78
|
| Rate for Payer: Cash Price |
$575.28
|
| Rate for Payer: Cofinity Commercial |
$618.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.78
|
| Rate for Payer: Healthscope Commercial |
$647.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.33
|
| Rate for Payer: Mclaren Medicaid |
$126.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.76
|
| Rate for Payer: Meridian Medicaid |
$133.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$206.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$197.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.24
|
| Rate for Payer: Nomi Health Commercial |
$589.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.33
|
| Rate for Payer: PACE Senior Care Partners |
$170.79
|
| Rate for Payer: PACE SWMI |
$179.78
|
| Rate for Payer: PHP Commercial |
$611.24
|
| Rate for Payer: PHP Medicare Advantage |
$179.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$625.62
|
| Rate for Payer: Priority Health Medicare |
$181.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.49
|
| Rate for Payer: Railroad Medicare Medicare |
$179.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.81
|
| Rate for Payer: UHC Core |
$600.45
|
| Rate for Payer: UHC Exchange |
$179.78
|
| Rate for Payer: UHC Medicaid |
$126.78
|
| Rate for Payer: UHC Medicare Advantage |
$179.78
|
| Rate for Payer: UHCCP Medicaid |
$126.78
|
| Rate for Payer: VA VA |
$179.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.33
|
|
|
HC CLOSED TX TRIMALLEOLAR FX W/O MANIP
|
Facility
|
IP
|
$719.10
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
76100534
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$500.49 |
| Max. Negotiated Rate |
$647.19 |
| Rate for Payer: Aetna Commercial |
$611.24
|
| Rate for Payer: BCBS Trust/PPO |
$593.90
|
| Rate for Payer: BCN Commercial |
$593.90
|
| Rate for Payer: Cash Price |
$575.28
|
| Rate for Payer: Cofinity Commercial |
$618.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$575.28
|
| Rate for Payer: Healthscope Commercial |
$647.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$539.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$611.24
|
| Rate for Payer: Nomi Health Commercial |
$589.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$539.33
|
| Rate for Payer: PHP Commercial |
$611.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$625.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$500.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$632.81
|
| Rate for Payer: UHC Core |
$600.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$539.33
|
|
|
HC CLOSED TX ULNAR FX PROX END
|
Facility
|
OP
|
$2,157.53
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
76100236
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$380.37 |
| Max. Negotiated Rate |
$1,941.78 |
| Rate for Payer: Aetna Commercial |
$1,833.90
|
| Rate for Payer: Aetna Medicare |
$560.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$674.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$674.23
|
| Rate for Payer: BCBS Complete |
$399.36
|
| Rate for Payer: BCBS MAPPO |
$539.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,773.71
|
| Rate for Payer: BCN Commercial |
$1,773.71
|
| Rate for Payer: BCN Medicare Advantage |
$539.38
|
| Rate for Payer: Cash Price |
$1,726.02
|
| Rate for Payer: Cofinity Commercial |
$1,855.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$539.38
|
| Rate for Payer: Healthscope Commercial |
$1,941.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,618.15
|
| Rate for Payer: Mclaren Medicaid |
$380.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$566.35
|
| Rate for Payer: Meridian Medicaid |
$399.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$620.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$593.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.90
|
| Rate for Payer: Nomi Health Commercial |
$1,769.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,618.15
|
| Rate for Payer: PACE Senior Care Partners |
$512.41
|
| Rate for Payer: PACE SWMI |
$539.38
|
| Rate for Payer: PHP Commercial |
$1,833.90
|
| Rate for Payer: PHP Medicare Advantage |
$539.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$380.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,877.05
|
| Rate for Payer: Priority Health Medicare |
$544.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,501.64
|
| Rate for Payer: Railroad Medicare Medicare |
$539.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,898.63
|
| Rate for Payer: UHC Core |
$1,801.54
|
| Rate for Payer: UHC Exchange |
$539.38
|
| Rate for Payer: UHC Medicaid |
$380.37
|
| Rate for Payer: UHC Medicare Advantage |
$539.38
|
| Rate for Payer: UHCCP Medicaid |
$380.37
|
| Rate for Payer: VA VA |
$539.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,618.15
|
|
|
HC CLOSED TX ULNAR FX PROX END
|
Facility
|
IP
|
$2,157.53
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
76100236
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,501.64 |
| Max. Negotiated Rate |
$1,941.78 |
| Rate for Payer: Aetna Commercial |
$1,833.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.90
|
| Rate for Payer: BCN Commercial |
$1,781.90
|
| Rate for Payer: Cash Price |
$1,726.02
|
| Rate for Payer: Cofinity Commercial |
$1,855.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,726.02
|
| Rate for Payer: Healthscope Commercial |
$1,941.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,618.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,833.90
|
| Rate for Payer: Nomi Health Commercial |
$1,769.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,618.15
|
| Rate for Payer: PHP Commercial |
$1,833.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,877.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,501.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,898.63
|
| Rate for Payer: UHC Core |
$1,801.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,618.15
|
|
|
HC CLOSED TX ULNAR FX, PROX END W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
76100275
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.52 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: Aetna Medicare |
$89.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.27
|
| Rate for Payer: BCBS Complete |
$63.54
|
| Rate for Payer: BCBS MAPPO |
$85.81
|
| Rate for Payer: BCBS Trust/PPO |
$282.19
|
| Rate for Payer: BCN Commercial |
$282.19
|
| Rate for Payer: BCN Medicare Advantage |
$85.81
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.81
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Mclaren Medicaid |
$60.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.11
|
| Rate for Payer: Meridian Medicaid |
$63.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PACE Senior Care Partners |
$81.52
|
| Rate for Payer: PACE SWMI |
$85.81
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: PHP Medicare Advantage |
$85.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Medicare |
$86.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: Railroad Medicare Medicare |
$85.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: UHC Exchange |
$85.81
|
| Rate for Payer: UHC Medicaid |
$60.52
|
| Rate for Payer: UHC Medicare Advantage |
$85.81
|
| Rate for Payer: UHCCP Medicaid |
$60.52
|
| Rate for Payer: VA VA |
$85.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
|
HC CLOSED TX ULNAR FX, PROX END W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
76100275
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.91 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: BCBS Trust/PPO |
$283.50
|
| Rate for Payer: BCN Commercial |
$283.50
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
|
HC CLOSED TX ULNAR SHAFT FX, W/O MANIP
|
Facility
|
OP
|
$343.26
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
76100252
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.52 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: Aetna Medicare |
$89.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.27
|
| Rate for Payer: BCBS Complete |
$63.54
|
| Rate for Payer: BCBS MAPPO |
$85.81
|
| Rate for Payer: BCBS Trust/PPO |
$282.19
|
| Rate for Payer: BCN Commercial |
$282.19
|
| Rate for Payer: BCN Medicare Advantage |
$85.81
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.81
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Mclaren Medicaid |
$60.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.11
|
| Rate for Payer: Meridian Medicaid |
$63.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PACE Senior Care Partners |
$81.52
|
| Rate for Payer: PACE SWMI |
$85.81
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: PHP Medicare Advantage |
$85.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Medicare |
$86.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: Railroad Medicare Medicare |
$85.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: UHC Exchange |
$85.81
|
| Rate for Payer: UHC Medicaid |
$60.52
|
| Rate for Payer: UHC Medicare Advantage |
$85.81
|
| Rate for Payer: UHCCP Medicaid |
$60.52
|
| Rate for Payer: VA VA |
$85.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
|
HC CLOSED TX ULNAR SHAFT FX, W/O MANIP
|
Facility
|
IP
|
$343.26
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
76100252
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.91 |
| Max. Negotiated Rate |
$308.93 |
| Rate for Payer: Aetna Commercial |
$291.77
|
| Rate for Payer: BCBS Trust/PPO |
$283.50
|
| Rate for Payer: BCN Commercial |
$283.50
|
| Rate for Payer: Cash Price |
$274.61
|
| Rate for Payer: Cofinity Commercial |
$295.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.61
|
| Rate for Payer: Healthscope Commercial |
$308.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.77
|
| Rate for Payer: Nomi Health Commercial |
$281.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$257.44
|
| Rate for Payer: PHP Commercial |
$291.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.07
|
| Rate for Payer: UHC Core |
$286.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.44
|
|
|
HC CLOSED TX ULNAR STYLOID FX
|
Facility
|
IP
|
$328.23
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
76100311
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.45 |
| Max. Negotiated Rate |
$295.41 |
| Rate for Payer: Aetna Commercial |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$271.09
|
| Rate for Payer: BCN Commercial |
$271.09
|
| Rate for Payer: Cash Price |
$262.58
|
| Rate for Payer: Cofinity Commercial |
$282.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.58
|
| Rate for Payer: Healthscope Commercial |
$295.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.00
|
| Rate for Payer: Nomi Health Commercial |
$269.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.17
|
| Rate for Payer: PHP Commercial |
$279.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$285.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.84
|
| Rate for Payer: UHC Core |
$274.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.17
|
|
|
HC CLOSED TX ULNAR STYLOID FX
|
Facility
|
OP
|
$328.23
|
|
|
Service Code
|
CPT 25650
|
| Hospital Charge Code |
76100311
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$57.87 |
| Max. Negotiated Rate |
$295.41 |
| Rate for Payer: Aetna Commercial |
$279.00
|
| Rate for Payer: Aetna Medicare |
$85.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.57
|
| Rate for Payer: BCBS Complete |
$60.76
|
| Rate for Payer: BCBS MAPPO |
$82.06
|
| Rate for Payer: BCBS Trust/PPO |
$269.84
|
| Rate for Payer: BCN Commercial |
$269.84
|
| Rate for Payer: BCN Medicare Advantage |
$82.06
|
| Rate for Payer: Cash Price |
$262.58
|
| Rate for Payer: Cofinity Commercial |
$282.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.06
|
| Rate for Payer: Healthscope Commercial |
$295.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.17
|
| Rate for Payer: Mclaren Medicaid |
$57.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.16
|
| Rate for Payer: Meridian Medicaid |
$60.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.00
|
| Rate for Payer: Nomi Health Commercial |
$269.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.17
|
| Rate for Payer: PACE Senior Care Partners |
$77.95
|
| Rate for Payer: PACE SWMI |
$82.06
|
| Rate for Payer: PHP Commercial |
$279.00
|
| Rate for Payer: PHP Medicare Advantage |
$82.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$285.56
|
| Rate for Payer: Priority Health Medicare |
$82.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.45
|
| Rate for Payer: Railroad Medicare Medicare |
$82.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.84
|
| Rate for Payer: UHC Core |
$274.07
|
| Rate for Payer: UHC Exchange |
$82.06
|
| Rate for Payer: UHC Medicaid |
$57.87
|
| Rate for Payer: UHC Medicare Advantage |
$82.06
|
| Rate for Payer: UHCCP Medicaid |
$57.87
|
| Rate for Payer: VA VA |
$82.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.17
|
|
|
HC CLOSED TX VERT BODY FX, W/O MANIP, REQUIRING/INCL CAST/BRACE
|
Facility
|
IP
|
$437.21
|
|
|
Service Code
|
CPT 22310
|
| Hospital Charge Code |
76100300
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$304.30 |
| Max. Negotiated Rate |
$393.49 |
| Rate for Payer: Aetna Commercial |
$371.63
|
| Rate for Payer: BCBS Trust/PPO |
$361.09
|
| Rate for Payer: BCN Commercial |
$361.09
|
| Rate for Payer: Cash Price |
$349.77
|
| Rate for Payer: Cofinity Commercial |
$376.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.77
|
| Rate for Payer: Healthscope Commercial |
$393.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.63
|
| Rate for Payer: Nomi Health Commercial |
$358.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.91
|
| Rate for Payer: PHP Commercial |
$371.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$380.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.74
|
| Rate for Payer: UHC Core |
$365.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.91
|
|
|
HC CLOSED TX VERT BODY FX, W/O MANIP, REQUIRING/INCL CAST/BRACE
|
Facility
|
OP
|
$437.21
|
|
|
Service Code
|
CPT 22310
|
| Hospital Charge Code |
76100300
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$77.08 |
| Max. Negotiated Rate |
$393.49 |
| Rate for Payer: Aetna Commercial |
$371.63
|
| Rate for Payer: Aetna Medicare |
$113.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.63
|
| Rate for Payer: BCBS Complete |
$80.93
|
| Rate for Payer: BCBS MAPPO |
$109.30
|
| Rate for Payer: BCBS Trust/PPO |
$359.43
|
| Rate for Payer: BCN Commercial |
$359.43
|
| Rate for Payer: BCN Medicare Advantage |
$109.30
|
| Rate for Payer: Cash Price |
$349.77
|
| Rate for Payer: Cofinity Commercial |
$376.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$349.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.30
|
| Rate for Payer: Healthscope Commercial |
$393.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.91
|
| Rate for Payer: Mclaren Medicaid |
$77.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.77
|
| Rate for Payer: Meridian Medicaid |
$80.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$125.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.63
|
| Rate for Payer: Nomi Health Commercial |
$358.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.91
|
| Rate for Payer: PACE Senior Care Partners |
$103.84
|
| Rate for Payer: PACE SWMI |
$109.30
|
| Rate for Payer: PHP Commercial |
$371.63
|
| Rate for Payer: PHP Medicare Advantage |
$109.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$380.37
|
| Rate for Payer: Priority Health Medicare |
$110.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$304.30
|
| Rate for Payer: Railroad Medicare Medicare |
$109.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.74
|
| Rate for Payer: UHC Core |
$365.07
|
| Rate for Payer: UHC Exchange |
$109.30
|
| Rate for Payer: UHC Medicaid |
$77.08
|
| Rate for Payer: UHC Medicare Advantage |
$109.30
|
| Rate for Payer: UHCCP Medicaid |
$77.08
|
| Rate for Payer: VA VA |
$109.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.91
|
|
|
HC CLOSE RX DIST FINGR FX
|
Facility
|
OP
|
$370.54
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
76100170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.33 |
| Max. Negotiated Rate |
$333.49 |
| Rate for Payer: Aetna Commercial |
$314.96
|
| Rate for Payer: Aetna Medicare |
$96.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$115.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$115.79
|
| Rate for Payer: BCBS Complete |
$68.59
|
| Rate for Payer: BCBS MAPPO |
$92.64
|
| Rate for Payer: BCBS Trust/PPO |
$304.62
|
| Rate for Payer: BCN Commercial |
$304.62
|
| Rate for Payer: BCN Medicare Advantage |
$92.64
|
| Rate for Payer: Cash Price |
$296.43
|
| Rate for Payer: Cofinity Commercial |
$318.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.64
|
| Rate for Payer: Healthscope Commercial |
$333.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.90
|
| Rate for Payer: Mclaren Medicaid |
$65.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.27
|
| Rate for Payer: Meridian Medicaid |
$68.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$101.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.96
|
| Rate for Payer: Nomi Health Commercial |
$303.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.90
|
| Rate for Payer: PACE Senior Care Partners |
$88.00
|
| Rate for Payer: PACE SWMI |
$92.64
|
| Rate for Payer: PHP Commercial |
$314.96
|
| Rate for Payer: PHP Medicare Advantage |
$92.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$322.37
|
| Rate for Payer: Priority Health Medicare |
$93.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.90
|
| Rate for Payer: Railroad Medicare Medicare |
$92.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.08
|
| Rate for Payer: UHC Core |
$309.40
|
| Rate for Payer: UHC Exchange |
$92.64
|
| Rate for Payer: UHC Medicaid |
$65.33
|
| Rate for Payer: UHC Medicare Advantage |
$92.64
|
| Rate for Payer: UHCCP Medicaid |
$65.33
|
| Rate for Payer: VA VA |
$92.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.90
|
|
|
HC CLOSE RX DIST FINGR FX
|
Facility
|
IP
|
$370.54
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
76100170
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.90 |
| Max. Negotiated Rate |
$333.49 |
| Rate for Payer: Aetna Commercial |
$314.96
|
| Rate for Payer: BCBS Trust/PPO |
$306.03
|
| Rate for Payer: BCN Commercial |
$306.03
|
| Rate for Payer: Cash Price |
$296.43
|
| Rate for Payer: Cofinity Commercial |
$318.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.43
|
| Rate for Payer: Healthscope Commercial |
$333.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.96
|
| Rate for Payer: Nomi Health Commercial |
$303.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.90
|
| Rate for Payer: PHP Commercial |
$314.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$322.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$257.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$326.08
|
| Rate for Payer: UHC Core |
$309.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.90
|
|
|
HC CLOSE RX FINGR ARTICULAR FX
|
Facility
|
OP
|
$358.31
|
|
|
Service Code
|
CPT 26740
|
| Hospital Charge Code |
76100169
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.17 |
| Max. Negotiated Rate |
$322.48 |
| Rate for Payer: Aetna Commercial |
$304.56
|
| Rate for Payer: Aetna Medicare |
$93.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.97
|
| Rate for Payer: BCBS Complete |
$66.32
|
| Rate for Payer: BCBS MAPPO |
$89.58
|
| Rate for Payer: BCBS Trust/PPO |
$294.57
|
| Rate for Payer: BCN Commercial |
$294.57
|
| Rate for Payer: BCN Medicare Advantage |
$89.58
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$308.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.58
|
| Rate for Payer: Healthscope Commercial |
$322.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.73
|
| Rate for Payer: Mclaren Medicaid |
$63.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.06
|
| Rate for Payer: Meridian Medicaid |
$66.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PACE Senior Care Partners |
$85.10
|
| Rate for Payer: PACE SWMI |
$89.58
|
| Rate for Payer: PHP Commercial |
$304.56
|
| Rate for Payer: PHP Medicare Advantage |
$89.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.73
|
| Rate for Payer: Priority Health Medicare |
$90.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.38
|
| Rate for Payer: Railroad Medicare Medicare |
$89.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.31
|
| Rate for Payer: UHC Core |
$299.19
|
| Rate for Payer: UHC Exchange |
$89.58
|
| Rate for Payer: UHC Medicaid |
$63.17
|
| Rate for Payer: UHC Medicare Advantage |
$89.58
|
| Rate for Payer: UHCCP Medicaid |
$63.17
|
| Rate for Payer: VA VA |
$89.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.73
|
|
|
HC CLOSE RX FINGR ARTICULAR FX
|
Facility
|
IP
|
$358.31
|
|
|
Service Code
|
CPT 26740
|
| Hospital Charge Code |
76100169
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$249.38 |
| Max. Negotiated Rate |
$322.48 |
| Rate for Payer: Aetna Commercial |
$304.56
|
| Rate for Payer: BCBS Trust/PPO |
$295.93
|
| Rate for Payer: BCN Commercial |
$295.93
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$308.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Healthscope Commercial |
$322.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PHP Commercial |
$304.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.31
|
| Rate for Payer: UHC Core |
$299.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.73
|
|
|
HC CLOSE RX PROX/MID FING SHFT FX
|
Facility
|
OP
|
$358.31
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
76100168
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.17 |
| Max. Negotiated Rate |
$322.48 |
| Rate for Payer: Aetna Commercial |
$304.56
|
| Rate for Payer: Aetna Medicare |
$93.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.97
|
| Rate for Payer: BCBS Complete |
$66.32
|
| Rate for Payer: BCBS MAPPO |
$89.58
|
| Rate for Payer: BCBS Trust/PPO |
$294.57
|
| Rate for Payer: BCN Commercial |
$294.57
|
| Rate for Payer: BCN Medicare Advantage |
$89.58
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cofinity Commercial |
$308.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.58
|
| Rate for Payer: Healthscope Commercial |
$322.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.73
|
| Rate for Payer: Mclaren Medicaid |
$63.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.06
|
| Rate for Payer: Meridian Medicaid |
$66.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.56
|
| Rate for Payer: Nomi Health Commercial |
$293.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$268.73
|
| Rate for Payer: PACE Senior Care Partners |
$85.10
|
| Rate for Payer: PACE SWMI |
$89.58
|
| Rate for Payer: PHP Commercial |
$304.56
|
| Rate for Payer: PHP Medicare Advantage |
$89.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$311.73
|
| Rate for Payer: Priority Health Medicare |
$90.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.38
|
| Rate for Payer: Railroad Medicare Medicare |
$89.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.31
|
| Rate for Payer: UHC Core |
$299.19
|
| Rate for Payer: UHC Exchange |
$89.58
|
| Rate for Payer: UHC Medicaid |
$63.17
|
| Rate for Payer: UHC Medicare Advantage |
$89.58
|
| Rate for Payer: UHCCP Medicaid |
$63.17
|
| Rate for Payer: VA VA |
$89.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.73
|
|
